The Covid-19 pandemic has brought to the surface something we have always known but rarely acknowledged: the importance of compassionate care when we or our loved ones are seriously ill or approaching the end of their lives.
Over the last year, we have all seen images of people dying in hospitals surrounded not by loved ones, but by beeping medical equipment and masked healthcare workers. We have heard the anguished stories of families separated from hospitalised loved ones they were not allowed to visit, waiting anxiously for potentially devastating news.
Many of us have experienced the loss of not being able to go through normal grieving rituals when someone dies because gatherings are not allowed, or funeral workers were overwhelmed.
The pandemic has underscored what most of us value: we want to be with family and loved ones and in a comforting environment even as we suffer.
Palliative care is a healthcare approach that seeks to achieve this. It focuses on improving the quality of life of people with life-limiting illnesses by alleviating pain and other symptoms, providing psychosocial and spiritual support to them and their families, and supporting relatives with their mourning processes when someone dies.
As a palliative care physician, I constantly see the remarkable impact it can have on people. I often recall JK, a man with advanced colon cancer who had experienced tremendous pain. After he started palliative care, he regained a sense of joy in life even though his cancer could not be cured. Having experienced the power of palliative care, he felt that anyone in his situation should have access to it and spent his last months advocating for Uganda to make palliative care available to all.
While the pandemic has highlighted the importance and near universality of this value, palliative care has long been neglected in much of the world. In Africa, it is not available at all or very limited; only 6 countries have widespread access.
Frequently, people with serious illness have to travel long distances to access these services, even though they can be provided at the community level. African governments and global health donors invest almost no resources in palliative care, leaving support for these services largely to the charities.
Many leaders worldwide, including in Africa, have embraced the mantra of “building back better” once the pandemic has been overcome. Palliative care is one area where they can do so, with enormous benefits for their people.
They can do so by committing to the integration of palliative care into universal health coverage systems many have pledged to roll out and ensuring that these services are publicly funded and available at all levels of care, including in communities so people who are very sick can be with or close to their families.
Strengthening palliative care in Africa is especially important today. With chronic diseases, such as cancer, diabetes and heart disease on the rise, rapid reductions in mortality from infectious diseases and aging populations, the need for palliative care is rising rapidly.
Because a vibrant palliative care community has done much of the leg work, the building blocks for a better system are readily available.
The African Palliative Care Association has developed a minimum package of palliative care services for universal health coverage, with needs for staffing, medications, and equipment calculated.
It is time for African leaders to include a commitment to palliative care in their plans to build back better.